PITCH: Do preventative health care interventions targeted at migrant groups focus only on behaviour and access or do they also consider upstream determinants?

Problem

Work exploring what it means to be healthy for asylum seekers and refugees

living in Glasgow suggests that upstream determinants, such as the asylum process, have a

large impact on lives. This has implications for all healthcare for this group, including

preventive care. A narrative systematic review is being developed, looking at the salience

of candidacy for preventive health care in migrant populations (asylum seekers, refugees and undocumented migrants) as well as identifying the role structural determinants play.

Aim: Determine whether preventative health care interventions targeted at migrant

groups focus solely on behaviour and access, or whether they consider upstream

determinants of health.

Approach

A search strategy focusing on preventive health care for marginalised migrant

groups has been developed. A range of databases have been searched and 33 papers

identified. Following quality appraisal, data were extracted using two theoretical

frameworks: candidacy (exploring individual’s access to and negotiation through

services) and structural vulnerability (considering upstream determinants of health, such

as poverty and racism).

Findings

Work mainly located in the US and UK. Migrant groups include migrant workers (mainly Hispanic) in the US, South Asians living in the UK, and asylum seekers. While most consider issues of candidacy, including identification of being a ‘candidate’ for a service and negotiation through healthcare, few consider the impact of upstream determinants.

Consequences

Considering there may be more commonalities than differences between different marginalised groups (from a structural determinants viewpoint), there is scope for this work to be repeated, for instance with homeless populations.